Radiation Therapy With Concurrent Weekly Carboplatin and Paclitaxol in Advanced Stage Unresectable Squamous Cell Carcinoma of the Head and Neck

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Presenter: Michael L. Haas, MDAffiliation: University of Maryland

Summary:Advanced squamous cell carcinoma of the head and neck region generally has a poor outcome with radiation therapy alone. This study was designed to evaluate concurrent chemoradiation therapy for the treatment of unresectable head and neck cancer.

Methods: From 1993-1998 62 patients received weekly carboplatin/taxol chemotherapy with radiation therapy. Radiation was delivered to a total dose of 70.2 Gy in 1.8 Gy fractions to the primary site. The majority of patients had oropharyngeal cancer.

Results:

The complete response rate was 82% at the primary site and 63% in the neck nodes.

Overall, 75% had no clinical evidence of residual disease at the completion of therapy.

With a median follow-up of 30 months, the overall survival at 3 years was 48%.

The local control rate at 3 years was 63%.

Clinical/Scientific Implications: The results of this Phase II study of concurrent chemoradiation are very encouraging for a disease that is notoriously difficult to control. Confirmation of this experience will require Phase III trials.